Active NPI
Jonathan R Kaczmarski, D.M.D.
- Pediatric Dentistry
- Gastonia, NC
National Provider Identifier
1982835831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 9201
- Practice address
- 890 Summit Crossing PL
Gastonia, NC 28054-2192 - Phone
- (704) 874-0345
- NPI assigned
- Jul 27, 2009
- Last updated
- Feb 4, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 8844 | NC | |
| Pediatric Dentistry | 1223P0221X | 9201 | SC | Primary |
Addresses
Primary practice location
890 Summit Crossing PL
Gastonia, NC 28054-2192
Mailing address
991 W Hudson Blvd
Gastonia, NC 28052-6430
Phone (704) 853-5191
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9201 | SC | MD | Professional Counselor |
| 8844 | NC | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612396800000",
"number": "1982835831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "991 W HUDSON BLVD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280526430",
"telephone_number": "704-853-5191",
"fax_number": "704-671-1404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "890 SUMMIT CROSSING PL",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280542192",
"telephone_number": "704-874-0345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KACZMARSKI",
"first_name": "JONATHAN",
"middle_name": "R",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-27",
"last_updated": "2021-02-04",
"certification_date": "2021-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NC",
"license": "8844",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "SC",
"license": "9201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
- Ruby Elizabeth Justice
- Justin D. Feasel
- Justin D. Feasel, MSW, LCSW, PLLC
- K. Jasinski, D.M.D., P.C. (Dental Care at Gaston Day)
- Jennifer E. Kacmar, MD
- Kalia Psychiatric Associates
- Anoop Kumar Kalia, M.D.
- Ciamack Kamdar, M.D.
- Karim Inc. (Unicare Family Homes)
- Karing Partners Enterprises (Senior Helpers of Gastonia)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.